Individual
YADIRA PEGUERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3014 W WILDER AVE, TAMPA, FL 33614-6700
(813) 562-6620
Mailing address
3014 W WILDER AVE, TAMPA, FL 33614-6700
(813) 562-6620
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102060100
—
FL
Enumeration date
01/25/2021
Last updated
03/28/2021
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